PT on the Net Research

Lupus


Question:

I would appreciate any information you have on training a client with Lupus.

Answer:

There are several forms of Lupus. Systemic Lupus Erythematosus (SLE) is probably the type you are referring to (the other types are extremely debilitating). When training someone with Lupus, you should be concerned about a few things. Some evidence exists regarding clotting and thrombolitic problems (blood clots). Heart valve disease seems to be common as does myofascial pain, and there seems to be an association between arthritis-fibromyalgia-chronic fatigue syndrome and Lupus. How they are interrelated no one knows. However, if we simplify the classification, then inflammatory disease will work.

People who have special needs like Lupus require a physician's clearance before training. This ensures there aren't any organs already affected by the disease. The next step is small amounts of work (five to 10 minutes) with cardiovascular benefits in mind (i.e., stationary bike, stairmaster, etc.). Rest as needed and stretch between sets. Lack of flexibility in the joints and muscles of Lupus patients seems to be noticeable. Strength work should also be held to small amounts of work: two to three exercises, three to six reps (light), two to four sets. Build strength, like the aerobic training, with small progressive steps. As the client adapts and does not experience undue fatigue, add a "little" more work.

Recovery from training can include contrasting baths, medications and massage therapy. Also check out the many articles on PTontheNet.com for ball exercises. The Swiss ball gives good support to the joints and work on the nervous system at the same time.

References:

  1. Roldan,C.et al. An Echocardiographic Study of Valvular Heart Disease Associated with Systemic Lupus. The New England Journal of Medicine. vol.335, no. 19. 1996
  2. Shapiro,S. The Lupus anticoagulant/ Phospholipid Syndrome. Annual Review of Medicine. vol47.pp553-553, 1996